As the U.S. braces for winter and flu season, the national COVID-19 vaccination effort is as urgent as it ever has been. Still, many Americans remain hesitant.

According to a recent survey conducted by the U.S. Census Bureau, 26,870,000 Americans — or 10.8% of the 18 and older population — say they will either probably or definitely not agree to receive the vaccination.

The share of Americans who will likely refuse vaccination varies considerably nationwide, from as many as 25.0% of the adult population to as little as 4.2%, depending on the state. States where the largest shares of adults are open to taking the vaccine are concentrated in the Northeast.

Many Americans who have yet to be vaccinated cite one of three reasons: either they are concerned about possible side effects, or they want to wait to see if it is safe, or it is difficult for them to obtain a vaccination. Others cite different reasons.

Nationwide, 17,000,000 people, 6.8% of the adult population, do not trust the COVID-19 vaccines, and another 9,970,000, or 4.0%, do not think COVID-19 is a big threat. Additionally, 15,250,000 American adults, or 6.1% of the 18 and older population, have not been vaccinated because they do not trust the government.

Meanwhile, the virus continues to spread. Since the beginning of the pandemic, there have been 45,968,940 confirmed cases of the virus and a total of 744,398 Americans have died as a result.

So far, 193,832,584 Americans — or 59.2% of the total population — have received the full course of vaccinations necessary to protect against COVID-19.

All survey data used in this story was published by the Census on Oct. 20, 2021. All data related to COVID-19 infections, fatalities, and vaccinations is current as of Nov. 5, 2021.

Alabama
> Adults who will likely or definitely refuse vaccination: 574,474 (15.5% of total)
> Residents who are fully vaccinated: 2,211,121 (45.2% of population)
> Confirmed cases of COVID-19 to date: 17,075 per 100,000 people (total: 834,582)
> COVID-19-related fatalities to date: 322 per 100,000 people (total: 15,734)

These are all the counties in Alabama where COVID-19 is slowing (and where it’s still getting worse).

Alaska
> Adults who will likely or definitely refuse vaccination: 71,259 (13.6% of total)
> Residents who are fully vaccinated: 387,489 (52.5% of population)
> Confirmed cases of COVID-19 to date: 18,351 per 100,000 people (total: 135,325)
> COVID-19-related fatalities to date: 96 per 100,000 people (total: 711)

These are all the counties in Alaska where COVID-19 is slowing (and where it’s still getting worse).

Arizona
> Adults who will likely or definitely refuse vaccination: 632,008 (11.3% of total)
> Residents who are fully vaccinated: 3,894,266 (54.3% of population)
> Confirmed cases of COVID-19 to date: 16,391 per 100,000 people (total: 1,175,520)
> COVID-19-related fatalities to date: 297 per 100,000 people (total: 21,273)

These are all the counties in Arizona where COVID-19 is slowing (and where it’s still getting worse).

Arkansas
> Adults who will likely or definitely refuse vaccination: 308,111 (13.7% of total)
> Residents who are fully vaccinated: 1,460,131 (48.4% of population)
> Confirmed cases of COVID-19 to date: 17,073 per 100,000 people (total: 514,539)
> COVID-19-related fatalities to date: 280 per 100,000 people (total: 8,434)

These are all the counties in Arkansas where COVID-19 is slowing (and where it’s still getting worse).

California
> Adults who will likely or definitely refuse vaccination: 2,365,289 (7.9% of total)
> Residents who are fully vaccinated: 24,408,625 (61.7% of population)
> Confirmed cases of COVID-19 to date: 12,436 per 100,000 people (total: 4,919,465)
> COVID-19-related fatalities to date: 181 per 100,000 people (total: 71,646)

These are all the counties in California where COVID-19 is slowing (and where it’s still getting worse).

Colorado
> Adults who will likely or definitely refuse vaccination: 383,544 (8.6% of total)
> Residents who are fully vaccinated: 3,573,208 (62.7% of population)
> Confirmed cases of COVID-19 to date: 13,221 per 100,000 people (total: 752,998)
> COVID-19-related fatalities to date: 146 per 100,000 people (total: 8,308)

These are all the counties in Colorado where COVID-19 is slowing (and where it’s still getting worse).

Connecticut
> Adults who will likely or definitely refuse vaccination: 163,900 (6.0% of total)
> Residents who are fully vaccinated: 2,533,601 (70.9% of population)
> Confirmed cases of COVID-19 to date: 11,314 per 100,000 people (total: 404,218)
> COVID-19-related fatalities to date: 246 per 100,000 people (total: 8,776)

These are all the counties in Connecticut where COVID-19 is slowing (and where it’s still getting worse).

Delaware
> Adults who will likely or definitely refuse vaccination: 73,104 (9.7% of total)
> Residents who are fully vaccinated: 585,901 (60.6% of population)
> Confirmed cases of COVID-19 to date: 14,967 per 100,000 people (total: 144,755)
> COVID-19-related fatalities to date: 217 per 100,000 people (total: 2,096)

These are all the counties in Delaware where COVID-19 is slowing (and where it’s still getting worse).

Florida
> Adults who will likely or definitely refuse vaccination: 2,001,810 (11.7% of total)
> Residents who are fully vaccinated: 12,904,395 (60.6% of population)
> Confirmed cases of COVID-19 to date: 17,165 per 100,000 people (total: 3,656,010)
> COVID-19-related fatalities to date: 279 per 100,000 people (total: 59,499)

These are all the counties in Florida where COVID-19 is slowing (and where it’s still getting worse).

Georgia
> Adults who will likely or definitely refuse vaccination: 953,321 (12.0% of total)
> Residents who are fully vaccinated: 5,161,287 (49.1% of population)
> Confirmed cases of COVID-19 to date: 15,577 per 100,000 people (total: 1,638,606)
> COVID-19-related fatalities to date: 279 per 100,000 people (total: 29,310)

These are all the counties in Georgia where COVID-19 is slowing (and where it’s still getting worse).

Hawaii
> Adults who will likely or definitely refuse vaccination: 128,084 (11.9% of total)
> Residents who are fully vaccinated: 851,175 (59.9% of population)
> Confirmed cases of COVID-19 to date: 5,762 per 100,000 people (total: 81,850)
> COVID-19-related fatalities to date: 64 per 100,000 people (total: 911)

These are all the counties in Hawaii where COVID-19 is slowing (and where it’s still getting worse).

Idaho
> Adults who will likely or definitely refuse vaccination: 200,570 (14.9% of total)
> Residents who are fully vaccinated: 791,498 (45.1% of population)
> Confirmed cases of COVID-19 to date: 16,787 per 100,000 people (total: 294,485)
> COVID-19-related fatalities to date: 205 per 100,000 people (total: 3,600)

These are all the counties in Idaho where COVID-19 is slowing (and where it’s still getting worse).

Illinois
> Adults who will likely or definitely refuse vaccination: 1,291,253 (13.5% of total)
> Residents who are fully vaccinated: 7,719,338 (60.6% of population)
> Confirmed cases of COVID-19 to date: 13,388 per 100,000 people (total: 1,705,777)
> COVID-19-related fatalities to date: 226 per 100,000 people (total: 28,772)

These are all the counties in Illinois where COVID-19 is slowing (and where it’s still getting worse).

Indiana
> Adults who will likely or definitely refuse vaccination: 549,873 (11.0% of total)
> Residents who are fully vaccinated: 3,370,358 (50.4% of population)
> Confirmed cases of COVID-19 to date: 15,331 per 100,000 people (total: 1,025,957)
> COVID-19-related fatalities to date: 252 per 100,000 people (total: 16,841)

These are all the counties in Indiana where COVID-19 is slowing (and where it’s still getting worse).

Iowa
> Adults who will likely or definitely refuse vaccination: 343,303 (14.7% of total)
> Residents who are fully vaccinated: 1,761,869 (55.8% of population)
> Confirmed cases of COVID-19 to date: 15,572 per 100,000 people (total: 491,463)
> COVID-19-related fatalities to date: 224 per 100,000 people (total: 7,069)

These are all the counties in Iowa where COVID-19 is slowing (and where it’s still getting worse).

Kansas
> Adults who will likely or definitely refuse vaccination: 300,751 (14.0% of total)
> Residents who are fully vaccinated: 1,561,245 (53.6% of population)
> Confirmed cases of COVID-19 to date: 15,050 per 100,000 people (total: 438,196)
> COVID-19-related fatalities to date: 221 per 100,000 people (total: 6,448)

These are all the counties in Kansas where COVID-19 is slowing (and where it’s still getting worse).

Kentucky
> Adults who will likely or definitely refuse vaccination: 442,935 (13.2% of total)
> Residents who are fully vaccinated: 2,282,061 (51.1% of population)
> Confirmed cases of COVID-19 to date: 16,744 per 100,000 people (total: 748,202)
> COVID-19-related fatalities to date: 221 per 100,000 people (total: 9,856)

These are all the counties in Kentucky where COVID-19 is slowing (and where it’s still getting worse).

Louisiana
> Adults who will likely or definitely refuse vaccination: 562,800 (16.4% of total)
> Residents who are fully vaccinated: 2,230,319 (47.9% of population)
> Confirmed cases of COVID-19 to date: 16,324 per 100,000 people (total: 760,691)
> COVID-19-related fatalities to date: 313 per 100,000 people (total: 14,585)

These are all the parishes in Louisiana where COVID-19 is slowing (and where it’s still getting worse).

Maine
> Adults who will likely or definitely refuse vaccination: 111,330 (10.4% of total)
> Residents who are fully vaccinated: 954,301 (71.3% of population)
> Confirmed cases of COVID-19 to date: 7,955 per 100,000 people (total: 106,469)
> COVID-19-related fatalities to date: 89 per 100,000 people (total: 1,197)

These are all the counties in Maine where COVID-19 is slowing (and where it’s still getting worse).

Maryland
> Adults who will likely or definitely refuse vaccination: 217,307 (4.7% of total)
> Residents who are fully vaccinated: 4,009,204 (66.3% of population)
> Confirmed cases of COVID-19 to date: 9,329 per 100,000 people (total: 563,696)
> COVID-19-related fatalities to date: 181 per 100,000 people (total: 10,939)

These are all the counties in Maryland where COVID-19 is slowing (and where it’s still getting worse).

Massachusetts
> Adults who will likely or definitely refuse vaccination: 372,915 (7.0% of total)
> Residents who are fully vaccinated: 4,826,732 (69.9% of population)
> Confirmed cases of COVID-19 to date: 12,430 per 100,000 people (total: 857,959)
> COVID-19-related fatalities to date: 276 per 100,000 people (total: 19,046)

These are all the counties in Massachusetts where COVID-19 is slowing (and where it’s still getting worse).

Michigan
> Adults who will likely or definitely refuse vaccination: 1,151,376 (15.1% of total)
> Residents who are fully vaccinated: 5,371,650 (53.7% of population)
> Confirmed cases of COVID-19 to date: 12,980 per 100,000 people (total: 1,297,496)
> COVID-19-related fatalities to date: 239 per 100,000 people (total: 23,879)

These are all the counties in Michigan where COVID-19 is slowing (and where it’s still getting worse).

Minnesota
> Adults who will likely or definitely refuse vaccination: 448,464 (10.6% of total)
> Residents who are fully vaccinated: 3,471,790 (61.9% of population)
> Confirmed cases of COVID-19 to date: 14,399 per 100,000 people (total: 807,956)
> COVID-19-related fatalities to date: 158 per 100,000 people (total: 8,885)

These are all the counties in Minnesota where COVID-19 is slowing (and where it’s still getting worse).

Mississippi
> Adults who will likely or definitely refuse vaccination: 273,266 (12.5% of total)
> Residents who are fully vaccinated: 1,369,586 (45.9% of population)
> Confirmed cases of COVID-19 to date: 16,931 per 100,000 people (total: 505,661)
> COVID-19-related fatalities to date: 339 per 100,000 people (total: 10,134)

These are all the counties in Mississippi where COVID-19 is slowing (and where it’s still getting worse).

Missouri
> Adults who will likely or definitely refuse vaccination: 715,721 (15.5% of total)
> Residents who are fully vaccinated: 3,073,465 (50.2% of population)
> Confirmed cases of COVID-19 to date: 14,020 per 100,000 people (total: 858,900)
> COVID-19-related fatalities to date: 199 per 100,000 people (total: 12,213)

These are all the counties in Missouri where COVID-19 is slowing (and where it’s still getting worse).

Montana
> Adults who will likely or definitely refuse vaccination: 148,198 (18.0% of total)
> Residents who are fully vaccinated: 543,478 (51.2% of population)
> Confirmed cases of COVID-19 to date: 16,848 per 100,000 people (total: 178,980)
> COVID-19-related fatalities to date: 226 per 100,000 people (total: 2,396)

These are all the counties in Montana where COVID-19 is slowing (and where it’s still getting worse).

Nebraska
> Adults who will likely or definitely refuse vaccination: 211,886 (14.9% of total)
> Residents who are fully vaccinated: 1,093,174 (56.7% of population)
> Confirmed cases of COVID-19 to date: 14,941 per 100,000 people (total: 288,257)
> COVID-19-related fatalities to date: 155 per 100,000 people (total: 2,988)

These are all the counties in Nebraska where COVID-19 is slowing (and where it’s still getting worse).

Nevada
> Adults who will likely or definitely refuse vaccination: 304,660 (12.7% of total)
> Residents who are fully vaccinated: 1,644,160 (54.2% of population)
> Confirmed cases of COVID-19 to date: 14,939 per 100,000 people (total: 453,297)
> COVID-19-related fatalities to date: 253 per 100,000 people (total: 7,677)

These are all the counties in Nevada where COVID-19 is slowing (and where it’s still getting worse).

New Hampshire
> Adults who will likely or definitely refuse vaccination: 72,443 (6.8% of total)
> Residents who are fully vaccinated: 860,830 (63.5% of population)
> Confirmed cases of COVID-19 to date: 10,157 per 100,000 people (total: 137,778)
> COVID-19-related fatalities to date: 117 per 100,000 people (total: 1,581)

These are all the counties in New Hampshire where COVID-19 is slowing (and where it’s still getting worse).

New Jersey
> Adults who will likely or definitely refuse vaccination: 365,889 (5.4% of total)
> Residents who are fully vaccinated: 5,929,982 (66.6% of population)
> Confirmed cases of COVID-19 to date: 13,496 per 100,000 people (total: 1,202,251)
> COVID-19-related fatalities to date: 314 per 100,000 people (total: 28,011)

These are all the counties in New Jersey where COVID-19 is slowing (and where it’s still getting worse).

New Mexico
> Adults who will likely or definitely refuse vaccination: 129,461 (8.1% of total)
> Residents who are fully vaccinated: 1,310,545 (62.5% of population)
> Confirmed cases of COVID-19 to date: 13,347 per 100,000 people (total: 279,670)
> COVID-19-related fatalities to date: 243 per 100,000 people (total: 5,085)

These are all the counties in New Mexico where COVID-19 is slowing (and where it’s still getting worse).

New York
> Adults who will likely or definitely refuse vaccination: 870,394 (5.9% of total)
> Residents who are fully vaccinated: 13,068,365 (66.9% of population)
> Confirmed cases of COVID-19 to date: 13,160 per 100,000 people (total: 2,571,790)
> COVID-19-related fatalities to date: 287 per 100,000 people (total: 56,116)

These are all the counties in New York where COVID-19 is slowing (and where it’s still getting worse).

North Carolina
> Adults who will likely or definitely refuse vaccination: 915,667 (11.4% of total)
> Residents who are fully vaccinated: 5,579,160 (53.7% of population)
> Confirmed cases of COVID-19 to date: 14,306 per 100,000 people (total: 1,485,455)
> COVID-19-related fatalities to date: 175 per 100,000 people (total: 18,191)

These are all the counties in North Carolina where COVID-19 is slowing (and where it’s still getting worse).

North Dakota
> Adults who will likely or definitely refuse vaccination: 99,685 (17.8% of total)
> Residents who are fully vaccinated: 365,140 (48.0% of population)
> Confirmed cases of COVID-19 to date: 19,796 per 100,000 people (total: 150,467)
> COVID-19-related fatalities to date: 235 per 100,000 people (total: 1,784)

These are all the counties in North Dakota where COVID-19 is slowing (and where it’s still getting worse).

Ohio
> Adults who will likely or definitely refuse vaccination: 1,201,824 (13.6% of total)
> Residents who are fully vaccinated: 6,096,447 (52.2% of population)
> Confirmed cases of COVID-19 to date: 13,313 per 100,000 people (total: 1,556,208)
> COVID-19-related fatalities to date: 212 per 100,000 people (total: 24,763)

These are all the counties in Ohio where COVID-19 is slowing (and where it’s still getting worse).

Oklahoma
> Adults who will likely or definitely refuse vaccination: 476,893 (16.4% of total)
> Residents who are fully vaccinated: 1,997,888 (50.7% of population)
> Confirmed cases of COVID-19 to date: 16,425 per 100,000 people (total: 647,637)
> COVID-19-related fatalities to date: 277 per 100,000 people (total: 10,929)

These are all the counties in Oklahoma where COVID-19 is slowing (and where it’s still getting worse).

Oregon
> Adults who will likely or definitely refuse vaccination: 364,356 (11.0% of total)
> Residents who are fully vaccinated: 2,666,106 (63.6% of population)
> Confirmed cases of COVID-19 to date: 8,825 per 100,000 people (total: 369,815)
> COVID-19-related fatalities to date: 107 per 100,000 people (total: 4,469)

These are all the counties in Oregon where COVID-19 is slowing (and where it’s still getting worse).

Pennsylvania
> Adults who will likely or definitely refuse vaccination: 1,355,301 (13.9% of total)
> Residents who are fully vaccinated: 7,819,038 (61.1% of population)
> Confirmed cases of COVID-19 to date: 12,299 per 100,000 people (total: 1,575,184)
> COVID-19-related fatalities to date: 248 per 100,000 people (total: 31,711)

These are all the counties in Pennsylvania where COVID-19 is slowing (and where it’s still getting worse).

Rhode Island
> Adults who will likely or definitely refuse vaccination: 64,399 (7.9% of total)
> Residents who are fully vaccinated: 755,703 (71.5% of population)
> Confirmed cases of COVID-19 to date: 17,070 per 100,000 people (total: 180,488)
> COVID-19-related fatalities to date: 272 per 100,000 people (total: 2,881)

These are all the counties in Rhode Island where COVID-19 is slowing (and where it’s still getting worse).

South Carolina
> Adults who will likely or definitely refuse vaccination: 585,948 (14.8% of total)
> Residents who are fully vaccinated: 2,593,961 (51.0% of population)
> Confirmed cases of COVID-19 to date: 17,711 per 100,000 people (total: 900,464)
> COVID-19-related fatalities to date: 271 per 100,000 people (total: 13,802)

These are all the counties in South Carolina where COVID-19 is slowing (and where it’s still getting worse).

South Dakota
> Adults who will likely or definitely refuse vaccination: 116,670 (18.2% of total)
> Residents who are fully vaccinated: 471,405 (53.4% of population)
> Confirmed cases of COVID-19 to date: 17,696 per 100,000 people (total: 156,123)
> COVID-19-related fatalities to date: 255 per 100,000 people (total: 2,253)

These are all the counties in South Dakota where COVID-19 is slowing (and where it’s still getting worse).

Tennessee
> Adults who will likely or definitely refuse vaccination: 683,908 (13.1% of total)
> Residents who are fully vaccinated: 3,276,561 (48.4% of population)
> Confirmed cases of COVID-19 to date: 18,974 per 100,000 people (total: 1,284,527)
> COVID-19-related fatalities to date: 243 per 100,000 people (total: 16,450)

These are all the counties in Tennessee where COVID-19 is slowing (and where it’s still getting worse).

Texas
> Adults who will likely or definitely refuse vaccination: 2,142,270 (10.0% of total)
> Residents who are fully vaccinated: 15,565,536 (54.2% of population)
> Confirmed cases of COVID-19 to date: 14,749 per 100,000 people (total: 4,233,278)
> COVID-19-related fatalities to date: 245 per 100,000 people (total: 70,293)

These are all the counties in Texas where COVID-19 is slowing (and where it’s still getting worse).

Utah
> Adults who will likely or definitely refuse vaccination: 326,405 (14.3% of total)
> Residents who are fully vaccinated: 1,734,414 (54.9% of population)
> Confirmed cases of COVID-19 to date: 17,603 per 100,000 people (total: 556,463)
> COVID-19-related fatalities to date: 103 per 100,000 people (total: 3,262)

These are all the counties in Utah where COVID-19 is slowing (and where it’s still getting worse).

Vermont
> Adults who will likely or definitely refuse vaccination: 20,299 (4.2% of total)
> Residents who are fully vaccinated: 447,124 (71.4% of population)
> Confirmed cases of COVID-19 to date: 6,033 per 100,000 people (total: 37,783)
> COVID-19-related fatalities to date: 57 per 100,000 people (total: 357)

These are all the counties in Vermont where COVID-19 is slowing (and where it’s still getting worse).

Virginia
> Adults who will likely or definitely refuse vaccination: 363,805 (5.6% of total)
> Residents who are fully vaccinated: 5,423,258 (63.7% of population)
> Confirmed cases of COVID-19 to date: 10,944 per 100,000 people (total: 932,173)
> COVID-19-related fatalities to date: 165 per 100,000 people (total: 14,089)

These are all the counties in Virginia where COVID-19 is slowing (and where it’s still getting worse).

Washington
> Adults who will likely or definitely refuse vaccination: 418,257 (7.1% of total)
> Residents who are fully vaccinated: 4,863,145 (64.5% of population)
> Confirmed cases of COVID-19 to date: 9,734 per 100,000 people (total: 733,535)
> COVID-19-related fatalities to date: 116 per 100,000 people (total: 8,727)

These are all the counties in Washington where COVID-19 is slowing (and where it’s still getting worse).

West Virginia
> Adults who will likely or definitely refuse vaccination: 204,387 (14.8% of total)
> Residents who are fully vaccinated: 736,505 (40.8% of population)
> Confirmed cases of COVID-19 to date: 15,201 per 100,000 people (total: 274,508)
> COVID-19-related fatalities to date: 249 per 100,000 people (total: 4,490)

These are all the counties in West Virginia where COVID-19 is slowing (and where it’s still getting worse).

Wisconsin
> Adults who will likely or definitely refuse vaccination: 663,532 (14.9% of total)
> Residents who are fully vaccinated: 3,415,322 (58.7% of population)
> Confirmed cases of COVID-19 to date: 15,361 per 100,000 people (total: 893,028)
> COVID-19-related fatalities to date: 163 per 100,000 people (total: 9,495)

These are all the counties in Wisconsin where COVID-19 is slowing (and where it’s still getting worse).

Wyoming
> Adults who will likely or definitely refuse vaccination: 108,252 (25.0% of total)
> Residents who are fully vaccinated: 256,745 (44.4% of population)
> Confirmed cases of COVID-19 to date: 18,071 per 100,000 people (total: 104,403)
> COVID-19-related fatalities to date: 215 per 100,000 people (total: 1,243)

These are all the counties in Wyoming where COVID-19 is slowing (and where it’s still getting worse).

Click here to see all coronavirus data for every state.

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